This application for re-selection as a Diabetes TrialNet Clinical Center consists of a leadership statement outlining our perspective and approach to address TrialNet's current challenges. It also describes our Clinical Center's current and planned activities to accomplish TrialNet's mission including innovative approaches to collaboratively and efficiently achieving our overarching goal - delaying and preventing the onset of clinical type 1 diabetes. The TrialNet Northwest Clinical Center recruitment region encompasses Alaska, Washington, Oregon, Idaho, and Montana. We work with more than a dozen Affiliate sites, local and regional T1D advocacy groups and diabetes health care providers to assure that those with T1D are aware that their relatives are at risk for disease and that screening along with the possibility of prevention trials through TrialNet are available. We also have significant recruitment efforts using digital media, including the use of websites, Facebook, Twitter, to convey information and foster discussion. More than 7500 individuals in our region have been screened for risk. TrialNet Northwest Clinical Center team members are active participants and are in leadership roles in the TrialNet network. We plan to work collaboratively within the new TrialNet structure to prevent or delay type 1 diabetes.